Medical Mystery #155 The case of the dark-colored urine

Good morning medical mystery readers! Today’s case lets you be the medical student and try your hand at diagnosing our patient. As I’m starting my pediatrics rotation today I decided to pick a relevant diagnosis; I hope you’re not getting tired of our recent bout of pediatric cases! Can you figure out what is responsible for all of his signs and symptoms?

A very worried father brings his 5 year old son to his pediatrician on a Saturday morning after scheduling an emergency visit. He reports the night before he noticed his son’s urine was unusually dark, similar to the color of cola. Before the doctor enters the room he is informed by the nurse who registered the patient that his vital signs contained an abnormal result:

Heart rate: 85

Blood Pressure: 135/90

Respiratory Rate: 20

Oxygen saturation: 100%

Temperature: 37°C (98.6°F)

The pediatrician begins by conducting a thorough physical examination of the child where he observes the following:

From: Pediatricsconsultant360.com

The rest of the child’s examination is unremarkable, although the he does appear to be noticeably tired. He does not complain of any pain or discomfort. Concerned about a particular diagnosis, the pediatrician asks if the child has had any recent illnesses, to which the father replies in a surprised tone that his son did have a sore throat about a week ago but it went away so he didn’t think anything of it.

Now feeling fairly secure in his clinical reasoning, the pediatrician orders a series of blood and urine tests to confirm the diagnosis. He reassures the father that the prognosis for his son’s condition is excellent.